Useful Member Documents & Links
PHARMACY POLICIES - GENERAL
ADDITIONAL PROGRAM BENEFITS
PHARMACY POLICIES - COMMERCIAL MEMBERS
Specialty Drug List
All unclassified drug codes (such as J3490, J3590, J8999 and J9999) require prior authorization. When requesting authorization for an unclassified drug, please submit the NDC#, Drug Name, and Dosage. Other Specialty Medications not listed on this list may be covered under your medical benefits. If covered, these drugs are subject to the cost-sharing specified in Attachment A and may be subject to Prior Authorization.
Small Group Forms and Resources
SMALL GROUP FORMS AND RESOURCES
Large Group Forms and Resources
LARGE GROUP FORMS AND RESOURCES
Pharmacy Policies - Commercial Members
Specialty Drug List All unclassified drug codes (such as J3490, J3590, J8999 and J9999) require prior authorization. When requesting authorization for an unclassified drug, please submit the NDC#, Drug Name, and Dosage. Other Specialty Medications not listed on this list may be covered under your medical benefits. If covered, these drugs are subject to the cost-sharing specified in Attachment A and may be subject to Prior Authorization.